CurrentCignaPolicy IP0712

Yorvipath

Defines Cigna coverage criteria for Yorvipath (palopegteriparatide) for treatment of chronic hypoparathyroidism in adults, including initial and continuation authorization requirements and limitations of use.

Policy Summary

PayerCigna

PolicyYorvipath

Policy CodePolicy IP0712

Change TypeNew policy

Effective DateFeb 15, 2025

Next Review DateN/A

Key ActionObtain prior authorization and approve for 1 year only if the patient meets the specified initial or continuation criteria, including baseline labs and insufficient control on calcium and active vitamin D.

SourceLink

POLICY UPDATE CHANGES

New policy establishing coverage criteria for Yorvipath (palopegteriparatide) for chronic hypoparathyroidism.

1 yearauthorization duration

Adultspatient population

≥7.8 mg/dLbaseline Ca threshold

Post-surgicalexcluded use

Coverage Criteria for Yorvipath (palopegteriparatide)

Initial Therapy and Continuation Therapy

Approve for 1 year if the patient meets ONE of the following (A or B):

Approval pathways: Pathway A: Initial Therapy OR Pathway B: Currently Receiving Yorvipath

A) Initial Therapy

A.i: Patient cannot be well-controlled on calcium supplements and active forms of vitamin D according to the prescriber
A.ii: Patient has sufficient 25-hydroxyvitamin D stores (baseline before initiating Yorvipath) according to the prescriber

Policy Summary

PayerCigna

PolicyYorvipath

Policy CodePolicy IP0712

Change TypeNew policy

Effective DateFeb 15, 2025

Next Review DateN/A

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

B) Currently Receiving Yorvipath

B.i: Patient cannot be well-controlled on calcium supplements and active forms of vitamin D according to the prescriber
Applies to continuation therapy
B.ii: Patient has sufficient 25-hydroxyvitamin D stores during Yorvipath therapy according to the prescriber
B.iii: Patient is responding to Yorvipath therapy according to the prescriber (examples: reduced oral calcium or active vitamin D dose and maintenance of a stable albumin-corrected serum calcium)
See response examples in policy

Provider Requirements, Authorization, and Monitoring

Prior Authorization

Prior Authorization Required

Prior authorization required. Approve for 1 year if the patient meets the specified initial therapy or continuation criteria per the FDA‑approved chronic hypoparathyroidism indication.

Authorization duration: 1 year

Documentation Required

Documentation of Prior Therapies Required

Patient must be unable to be well‑controlled on calcium supplements and active forms of vitamin D as documented by the prescriber before initiating or continuing Yorvipath. Prescriber documentation should describe prior therapies and evidence of inadequate control (for example, persistent hypocalcemia or inability to reduce supplemental calcium/active vitamin D doses).

Documentation Required

Pre‑initiation Laboratory Requirements

Before initiating Yorvipath, within 2 weeks confirm serum 25‑hydroxyvitamin D is within the normal range and that albumin‑corrected serum calcium is ≥ 7.8 mg/dL (or ionized serum calcium ≥ 4.4 mg/dL) per prescriber assessment.

Denial Risk

Not Covered: Acute Post‑Surgical Hypoparathyroidism

Use of Yorvipath for acute post‑surgical hypoparathyroidism is considered experimental, investigational, or unproven and is a basis for noncoverage.

Background on Yorvipath (palopegteriparatide)

Yorvipath (palopegteriparatide) is a parathyroid hormone analog corresponding to PTH (1‑34) indicated for the treatment of hypoparathyroidism in adults. It is intended for chronic hypoparathyroidism management and was evaluated in adults who first achieved target calcium levels using conventional therapy. Baseline and ongoing laboratory monitoring — including verification of adequate 25‑hydroxyvitamin D stores and measurement of albumin‑corrected serum calcium (or ionized calcium) — are part of the clinical context for initiating and continuing therapy.

OpenPayer

Yorvipath

Coverage Criteria for Yorvipath (palopegteriparatide)

Laboratory Thresholds / Key Clinical Values

Provider Requirements, Authorization, and Monitoring

Background on Yorvipath (palopegteriparatide)

Response to Therapy — Definition